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Discouraged with the system and losing hope

by Dr. Marie Hartwell-Walker February 22nd, 2019
written by Dr. Marie Hartwell-Walker

Lately I feel like I’ve been getting kicked around and going nowhere. I was released from the psych unit at the hospital on Wednesday following a 12-day involuntary stay. My preceptor (psychiatrist) thought I might be a danger to myself and had me admitted against my will. Although I was having suicidal thoughts, I’m bipolar. This honestly happens to me all the time, and I was never in any acute danger. Obviously she didn’t believe me.

While I was in the hospital, I dealt with two separate psychiatrists who had totally different opinions of me and completely different treatment plans. The first guy didn’t even want to bother with me. He brushed me off in such a callous way that I was very hurt, even crushed. The second guy was more open-minded and thought it would be worthwhile to try me on an MAOI, which I have never taken before. He discontinued the wellbutrin I was taking on the assumption that my outpatient psychiatrist would go along with that plan (he even talked to him about it). On Friday, my outpatient psychiatrist said that he didn’t like the MAOI idea and that I should go back to the meds I was taking prior to hospitalization, except without the antidepressant. (Take a depressed person and remove the antidepressant… good plan.)

So what did my hospitalization accomplish for me? Well, it screwed up my schooling. Now I have to take a leave of absence, repeat my psych rotation, and delay my graduation by months. It also did nothing to change my mood. I’m just as depressed as I was before, but with an altered set of stressors now. There have been no promising changes in my treatment plan. I gave the docs over a week of my cooperation as an inpatient in the hopes that they could help me, but it now seems that the entire ordeal was a complete waste of my time and a rather disruptive/destructive force in my life. I can’t think of anything good that has come of this. Nothing.

I’m going into medicine. I’ve always had an interest in psychology. However, this experience has done nothing but leave me disappointed and disheartened. Disappointed that those who are providing my care can’t agree with each other. Disappointed that I would be callously brushed off when I am in genuine pain. Disappointed that one would get my hopes up, and another would put me right back where I was before. Disheartened because when I finally made myself vulnerable and accepted a need for help (like frequent suicidal ideations maybe aren’t normal or healthy), I received three different responses and have made no progress whatsoever. Disheartened because I’m starting to feel like I can’t be helped (or at least no one wants to try). Now THAT’S depressing.

A recommendation has been made for therapy, and I’ll agree that I need it, but I don’t want to put all of my eggs in that basket. I’ve done therapy before. Years’ worth, and it has only been a moderate help. I know I don’t handle stress well, but my history includes bouts of major depression even when everything in my life is going well. Can therapy fix that? Really?

Obviously I’m venting, but I need to know – how do I overcome this frustration, discouragement, and newly-found skepticism as I try to pursue care from the people who I feel have let me down so badly, and who seem to be tired of dealing with me? I haven’t quite given up on myself yet, but sometimes I think I’m really close to throwing up my hands and calling it quits too. That’s when suicide starts to sound so inviting again, because sometimes I think I would rather die than live like this for another 50+ years. I need a reason to hope.

Thanks.

Thank you for writing. I hope you won’t give in and give up. You obviously are thinking hard about options and trying to take charge of your life. I’m very, very sorry that you seem to have been caught in the gaps of the current health care system. Each doctor was undoubtedly doing what they thought best. But it’s frustrating that there wasn’t more collaboration among them. I’m not surprised if at times you want to throw up your hands in dismay. It may be a small comfort to know that many people with a bipolar diagnosis try for years before they get the right providers and the right strategy to manage their illness.

The good news is that it can be managed. Yes, talk therapy helps. I recently attended a reading by David Lovelace who is the author of Scattershot, My Bipolar Family. He also has bipolar illness. He joked that his mechanic takes longer to change the oil in his car than his psychiatrist takes to review and prescribe his meds. Psychiatrists often have to see 3 or 4 people an hour; not exactly a pace where they can dig in and understand what is going on with someone. That’s why the talk therapy piece is so important as a long-term strategy. Your therapist can help you understand your illness better and learn strategies for coping with it and even using its positive aspects. Ideally, there should be a partnership and good communication between your psychiatrist and your therapist and you. Learning how to live with bipolar illness is a process of self-discovery; not just a matter of popping the right pills.

I think you might find it helpful – even inspiring – to read the books by Kay Redfield Jamison and the previously mentioned book by David Lovelace. You are indeed in very good company. Many people with a diagnosis of bipolar are extremely bright, creative, and productive people. Once they learn how to live with the illness, they become their best versions of themselves.

I wish you well.
Dr. Marie

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Married out of obligation

by Dr. Marie Hartwell-Walker March 31st, 2019
written by Dr. Marie Hartwell-Walker

I am 34 years old and we have been married for almost 4 years. I had been dating her for about a year while living and working in my hometown when I received a job opportunity to work in another country. I then moved there and towards the end of the third year, and finding my friends getting married, I thought I should get married too and since she had been with me throughout the long distance relationship, I felt I should marry her. I felt it was the right thing to do. Or out of obligation I felt I had to marry her.

From the honeymoon things were not very smooth with us having close to no sex and for the first time I finding myself not attracted to her. After the marriage ceremony, she moved in to my place and eversince, our marriage has been going through constant arguements with close to no sex (maybe 2~3 times year). Before marriage, I was an overall happy guy, maybe a little concerned about the direction of my career at times but, always finding refuge and peace at home. After I brought her into my life, I was no longer finding this peace at home, and the couple life without sex was something I just could not understand.

But I do attribute a part of this problem to myself as I find myself physically not attracted to my wife, which is something I should’ve dealt with before plunging into the marriage. And with her attempts to avoid sex and hide herself while dressing, this lack of attraction has gotten worse. Because I was not finding peace and comfort at home, I often found myself hanging around the neighbourhood park after work, drinking a beer and preparing myself for home.

One of the arguements she would say was why I chose to marry. I genuinely feel that I had not really thought through the marriage and I am paying the consequences. Life overseas got difficult as I was unable to find comfort in my own home and eventually I left my job to return to my home country. I was secretly hoping that she would then leave me as I chose to go work for a company that paid less and
was not a specialized firm. I now found myself working for a company I did not wish to work for, with lower salary, and yet still having discomfort at home.

Things really hadn’t changed and I was now worse off than before. She does mention that she would like to have kids sometime next year but I find myselft thinking do I really even want to have children with this women? Maybe after the numerous arguements that she has lost all respect for me but I often find myself being talked down by her and even in public. She has a close friend who got married around the time that we did but recently divorced. The man had left home to return to his parents home and the wives were having a laugh over it.

I can see that I should’ve dealt with the problem of my not being physically attracted to her before deciding to get married but her disrespect for me now is the last straw. I really see no meaning to this marriage. From our arguements, I have left home a couple of times to return in a few days. I have stayed at my parents place or motels. When we now argue, she picks up the suitcase and tells me to please leave and think about the marriage and herself for a few months and then come back.

I really am at a loss as to what I should do. I have since left the low paying job to go at it alone but living at home with her is just becoming unbearable.

There is a truism that relationships tend to end as they began. You married out of some mistaken idea of obligation. Now you find you can’t leave, in spite of all the ways the relationship is unsatisfying.

What I don’t understand is why your wife stays with you, much less wants to make a family with you. You have let her know that don’t find her attractive and that you think your marriage was a mistake. To hold onto some self-respect, she lets you know that she isn’t interested in sex with you and she makes home uncomfortable for you. The two of you are in some kind of standoff of mutual disrespect.

I’m sure I don’t understand the nuances of Asian culture that makes this all make a kind of sense. In America, I would urge the two of you to see a marriage counselor to see if there is any way to either make a marriage that works for you or to help you part company in a way that is as agreeable as possible. Either direction would let the two of you move forward in life. If marriage counselors are available in your country, I hope you will consider making an appointment.

I do know from experience that arranged marriages between very different people can work – if both people are genuinely committed to making each other happy. If one or both of you can’t do that, I hope there is a way for you to separate and wish each other luck in finding a loving partner. You both deserve a happier life.

I wish you both well.
Dr. Marie

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Will boyhood same sex experiences affect romance with girlfriend?

by Dr. Marie Hartwell-Walker April 22nd, 2019
written by Dr. Marie Hartwell-Walker

About a year ago some memories seemed to come to the surface all of a sudden with no obvious catalyst. All I can recall is that when I was about 6,7, or 8, my older brother (4 years older) took me into my dad’s private office where we would play a “game.” I’ll just be blunt because there isn’t much of a point in beating around the bush. He told me that if I performed oral sex on him, then I would get to choose the next “game” we played. The thing is, I don’t remember if I was okay with this or not. I don’t remember being specifically scared or unsure about doing this, but all I can remember is doing it as if it was a silly game. I remember it as if I was excited to be spending “quality” time with my older brother.

The memory I have of the incident is heavy in physical detail. For example, I remember a stain on my dad’s carpet that I was kneeling on and I can recall the game I chose to play after his “turn” was over.

The thing is, I don’t understand why I would all of a sudden recall such a traumatic (is it?) incident without any sort of trigger. And I can’t seem to remember what led to that moment in my dad’s office nor can I remember where my dad was at the time. (My dad and mom were divorced and we spent weekends at his house and I can’t imagine him leaving us alone when the oldest was probably only about 10 or 11.)
Also, I don’t really think of this experience as a traumatic one. I simply remember it as a scenario of “Boys will be boys.”
So, my first problem is not knowing if this actually happened.

Also, if this did actually happen, I wonder if it might have affected my adolescent sexuality. I remember having other similar relationships, minus the oral sex, with some friends closer to my age, but none of them ever being of the opposite gender.

I think the pseudo-homosexual relationships I had with my childhood friends may have lead to some of my teenage feelings of hate and contempt for the act of intercourse, especially in women. I had these feelings originally from about ages 14 through 16, but recently have been in a relationship for about a year and those feelings seem to have faded. (Well, at least for my girlfriend.)

I wouldn’t say I’m bisexual or even bicurious, but I can definitely admit to knowing whether or not a male is good-looking. I will even say that I have a personal preference.

I’m sorry for being so disorganized with my problems, but I think I’ve just now realized what I wanted to ask.
I have talked to my girlfriend about all of my aforementioned thoughts and memories, but seeing as she is not a psychologist, she could only slightly console me.

My main worry is this though: If my memories are not false ones, and I was molested as a child, is it likely that I lash out or overreact in some way and wind up ruining the relationship that I currently have?
This is probably my biggest fear.
I can honestly say I’ve never been happier in my life with my girlfriend and I want to do absolutely everything to make it last.

Thank you!

A: You are a very thoughtful and introspective person. I can tell that you are doing your best to protect a relationship with your girlfriend that is very special to you. I think I can be reassuring.

First: It’s not at all unusual for preadolescent boys to explore their emerging sexuality with each other. Often they participate in checking out each other’s genitals and seeing if they “work.” As for the incident with your brother: If it happened, it was certainly inappropriate. But inappropriate doesn’t necessarily equal traumatizing. You don’t remember being coerced or hurt. Apparently it didn’t continue. Another kid might have been psychologically distressed by this but people don’t all respond to events in the same way. You were able to let it go.

There’s no way for me to tell if it did or didn’t happen. All I can tell you is this: If it did occur, your brother – who was about 11 at the time – may have been doing that same preadolescent exploring you did later. You may have intuitively understood that which may be why it didn’t have a negative impact on you.

As for the period of being repulsed by the idea of intercourse when you were in your early teens: That too isn’t unusual. As much as young boys like to show off by talking about sex, often they are somewhat frightened by the idea. It’s easier to deal with being disgusted than with being afraid so they hide their fear behind contempt.

Now you are older and in your first important relationship. As you begin to have sexual feelings for this person you care about, old memories and thoughts get stirred up to the surface. Think of them as being like snapshots you’d forgotten and found underneath some papers in a drawer. You take a look and then put them aside. They happened when you were young and aren’t relevant any more.

I sincerely doubt that those early experiences are going to threaten your relationship with your girlfriend. The two of you have the kind of relationship where you can talk about highly personal issues and worries. She is supportive. You are caring. The two of you want the relationship to last and are willing to work on things together. This all sounds really positive. I think you can stop worrying about the past and just enjoy the present.

I wish you well.
Dr. Marie

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My spouse is acting crazy

by Dr. Marie Hartwell-Walker April 4th, 2019
written by Dr. Marie Hartwell-Walker

i am separated from my spouse. i don’t know where she is or what she’s doing. we have been together for four years, always off and on. not because we don’t love each other, but because of these bizarre patterns of behavior… here is a summary of us as individuals- i am a mother, have a six figure job, managing a horse farm that breeds and sells racehorses. i have a ten year old son, a home, a mortgage, and tons of responsibility. she is a few years younger than i am, and has just a ton of amazing qualities, but has struggled her whole life. she has never finished school, and moves in and out of her parent’s house all the time, and has never been able to keep a job for more than a month or so. we have been in a relationship for four years, and made our lifelong commitment in a ceremony one year ago…
our relationship follows a cycle that has become very predictable- after a separation that usually lasts one to two months, she will get herself together, stop smoking dope, stop the drinking and partying, and we get back to our life together… we have tons of sex, do projects together, the finances are fine, everything is like a dream come true… then, things unravel, and fast… she will be ‘sick”, and start calling into work, want to drink more, and starts fighting with me about wanting to smoke dope as a way to deal with life… i never relent, because drugs are not a part of my life, and never will be, and usually the next phase is her just calling off work for a week or more at a time, and spending a lot more time sleeping (11-13 hrs per day), and getting herself up and out the door before i get home from work… after a few days of this, we are of course not getting along, because she is pushing me away, running around with all kinds of weird people, and expecting me to support her financially… also, the other big change is that she gets very aggressive verbally- she will start to call me all kinds of nasty names, and just act like a completely different person that happens to look identical to the person i want to spend my life with… i have perimeters for our relationship that i will not compromise on, like drugs, alcohol, not working, etc… so, when she loses her job, which always happens, or she quits because she hates it all of a sudden, she packs her things and is gone… she will move back into her mother’s house, and party constantly- sleep all day, and party all night. i’m not exactly sure what this phase entails, since we usually do not speak much during these times, but i think she binge drinks, chases other women (but does not typically sleep with them), and basically bottoms out. she is also very very angry, having many verbal confrontations, and sometimes a actual physical altercation with someone. the only other facet i have learned from a mutual friend is that she will tell lies- big ones- about herself, our relationship, etc… they seem to center around money, importance, etc…
as far as mental health goes, we are both adhd, although i am medicated now, which has made my life totally different, and she is not.
i know my life and this situation sounds totally insane, and i don’t have a support system with my family or friends… but when this cycle starts all over again, she is the person i fell in love with, and she has such a close relationship with my son… on a side note, none of these weird behaviors ever involve my child… she has never been anything but polite, caring, and involved in his life… she has never raised her voice towards him or anything… when she is acting normal, she is a fun, caring, family oriented human being… but when she starts to go downhill, all bets are off. it’s like a stranger is inside her, and i can’t even reach her anymore.
currently, we are apart, and have been for most of this year… she says she loves me, but she hates me. she is in the phase where everybody is out to get her. whether we make it or not, i love her, and worry about her, and i don’t want to abandon her. the only contact we have right now is when she calls to tell me she loves me… and i get reports through our mutual friends, which are few, that she talks about me and how much she misses me and loves me…
this situation is so far out of my league, i honestly don’t know what to do. in the past, i have tried forgetting about her, i have tried dating other people, but i have no desire to even do that. i am in love with her, and i need some help… basically to help me know what to do. i know that i can’t force her to seek treatment, and with her lack of healthcare, there’s not much available for her that i’m aware of. i am a big believer in commitment, and i have never felt like i want to turn my back and just walk away, although i also know i won’t allow these rollercoaster rides to ruin my son’s life or mine. help me please!!!

How very painful this must be – for both of you. When things are good, they’re wonderful. But the bad times are eroding the relationship.

I can’t diagnose someone on the basis of a letter, of course. I do think your spouse needs an evaluation by a psychologist or psychiatrist. If she were to see me, the information you presented would lead me to consider whether she is suffering from bipolar disorder. You might want to look up that diagnosis in the Psych Central library and see if it fits. If I’m right, the good news is that this is a treatable illness. A combination of medication and talk therapy would help her learn to manage herself better. Allowing you to participate at least some of the time in the therapy sessions would help you learn some ways to help her recognize when she is losing control and how to help her put on the brakes.

When I did some searching on the web, I found a number of mental health clinics in your city. Such clinics usually offer care on a sliding fee scale, accept insurance, or have some free care. You could also ask your doctor about places in your area that offer affordable mental health services.

Loving, wonderful relationships are hard to find. I hope you both will do your best to find the help you need to stay together.

I wish you well.
Dr. Marie

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I can’t socialize if I don’t have a friend with me

by Dr. Marie Hartwell-Walker September 28th, 2019
written by Dr. Marie Hartwell-Walker

When I think back, I never could socialize on my own. I always needed someone that introduced me to somebody else. Whether my parents, other friends or my sister.
I’m getting sick of it, because I know that there won’t always be someone I know around that introduces me to somebody else.

I’m not even able to ask strangers simple questions, for example where street XXX is and how I can get there. Or can’t ask sellers if they have something, even I know they won’t kill or eat me up. All they can say is “No, I’m sorry.”

The only one I could get to know on my own was that one girl, I really really like her, she seems to be a pretty good friend, and she’s just like me. Also has only a handful of friends and rarely talks with strangers. She’s in my class and I sit next to her, so it wasn’t that hard talking with her. But I could never go to Starbucks and get to know people I haven’t seen before.

I’m also starting to isolate myself. I rarely leave the house even I want to.
But it just seem to make no sense walking around all alone.
I also always loved photography, don’t get me wrong, still love it, but it’s like I stopped making pictures like I used to, and I have no idea why. We have a huge garden and a huge house. My neighbors don’t. My neighbors are often outside, and I don’t wanna go outside and prepare things for making a picture when they’re out. I know I shouldn’t bother, but I don’t want them to see what I’m doing.

It’s not that I hate other people or don’t get along with them. They just seem to dislike me.
And they keep breaking up contact after a couple of years. Whether they move away or just stop talking with me. I suppose it’s just something like a cure. haha. I mean, I really have no idea why people leave me.

I have this friend, the only one from kindergarten I still talk to. He said I’m like the best friend someone could ever have and I’m not boring at all. He said, I’m more interesting than all those kids that have a billion friends together, he doesn’t understand why they constantly stop talking with me, because I’m neither boring or ugly nor I’m conceited at all. The only thing he could imagine is that they might me jealous or something, because I have like a lot of material things. (But only because my parents are rarely at home and work about 25/7) Sooo they don’t have to be jealous because I don’t brag.

Once, I had a therapist, even she left me, because she got pregnant. She told me she’ll call me. I’m still waiting for that call, and yes I miss talking with her, even she didn’t really helped, but it just felt great talking about problems.

Spoke verbosely, sorry. I hope you kind of understood my problem and can help me.
And so so sorry for the long text.

What you are describing could possibly be a social anxiety disorder. People with this problem fear situations in which they might end up embarrassed or where they think other people might be judging them. When they meet new people or think someone is watching what they are doing, they get anxious or uncomfortable and generally withdraw. Often they start avoiding situations where there are other people unless they are with someone they trust.

One of the big problems with this disorder is that it can become a vicious cycle. The person is afraid of making a fool of himself or being judged so he doesn’t try to meet new people or do new things. He then ends up feeling lonely and believing that he can’t make friends or do things – which makes him more reluctant to try. And so it goes.

My guess is that people don’t talk with you because you aren’t comfortable talking with them. They then get the wrong impression about you. You are lucky to have a friend who gives you some honest and more objective information. It sounds like you have everything you need to be a social person – except confidence.

You were right to see a therapist. You did like talking to her. Perhaps if it had gone on longer, it would have been more helpful. Please don’t take it personally that she didn’t call you back. My guess is that it didn’t have anything to do with you. Her personal life got in the way of her good intentions.

Do yourself a big favor and give another therapist a go. In the safety of a therapist’s office, you can figure out some strategies for being more confident in front of other people and for managing the anxiety. Your old friend is probably right about you. When you figure out how to let people get to know you, you’ll be fine.

I wish you well.
Dr. Marie

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Too too angry

by Dr. Marie Hartwell-Walker June 20th, 2019
written by Dr. Marie Hartwell-Walker

From a 14 year old girl: I don’t understand what is wrong with me. I used to be a happy little child. I know what you’re probably thinking, you’re going through puberty, horomones are crazy, but that’s not what’s it. I’m not going through some “teen-angst” state. There are multiple holes in my wall from me punching it. I’ve thrown my chair at my bed. I’ve thrown my phone at the wall when someone pissed me off when I was talking to them. I’ve punched quite a few mirrors in my house, the bathroom, my mom’s mirrored closet doors, my mirror. I’ve kicked a keyboard in half. I broke a girls arm.
I get depressed too easily, too. After one of my angry episodes, like metioned above, I’ll start crying because I feel horrible for what I’ve done. The time after I punched my mirror I accidently hit my dog, not even that hard, and he just walked away unscathed and I was laying on the floor crying my eyes out. I used to cut myself. Sometimes I get to the point where I want to so badly, but I remembered how hurt my mom was when I last did it. Plus I ended in the local behavioral health center, and I’d rather not go back there.
When I get angry everything gets quite blurry and I lose my clarity of everything else. Nothing else matters to me, but what I am angry about. Someone could be contemplating murder, and I would be focused on something entirely different. I start twitching really badly. When I get angry I will push my fingernails in to my legs and breathe heavily. I try to calm myself down and it just doesn’t happen.
The littlest things bother me. Someone says the phrase “dilly-dally” and I want to beat them. If I’m already bothered and someone attempts to touch me, I get really angry. When people tell me what to do, I get bothered. When people spell things wrong, I get bothered. When people make fun of other people, I get REALLY bothered.
I can honestly say I’ve never been emotionally strong. In about fourth grade I went through the school counsuling system, and the counsuler said I had Anxiety issues. I think it may be more than that.
Sometimes when I get angry I get really hyper as well. I’ll start running around the house, often to run into things and get even more pissed off. I cuss too much, and I often drop the f-bomb way more than I should. My mind will start wandering, which is not a real good thing for me. Not to sound cocky, but I’m really smart and quite artistic.
I’m content only at about two in the morning. Which it is right now. And this lasts for only about an hour.
These moods change about every day or two. Sometimes even a week.
When I’m in my hyper-mode, I believe I can do anything. I even placed a bet with someone that I could walk through my door. I tried and I even argued with my friend that I did do it. Even though, thinking back (while I’m content), I know I didn’t.
What’s wrong with me? I know this isn’t just me being a teenager. None, I mean none, of the population that attends my school go through stuff like this. They are generally very happy people.

You are absolutely right. What you are describing is not usual teenage angst or the expected emotional storms of puberty. I admire your courage. You are looking squarely at yourself and you are reaching out for some help.

I can’t make a diagnosis on the basis of a letter, of course. I don’t have enough information. What I can suggest is this: First, talk to your parents if you can. You need their emotional support. And you need some help making your way through the health system and getting services paid for. If you don’t think your parents will be sympathetic, start with your school counselor or your school nurse.

Then ask for a complete medical checkup. Thyroid problems, anemia, even an electrolyte imbalance, for example, can cause depression and erratic behaviors. I always want to rule out the physical before we start thinking about the psychological. If you are medically fine (which is a great thing to know), then see about getting a psychological evaluation. Ask your doctor for a recommendation or go on the web. When I searched “mental health services” and the name of your town, I found several places that specialize in youth.

In the meantime: If you feel yourself getting out of control, please consider calling a support line. The folks at the BoysTown crisis line at (800) 448-3000 are there 24/7 to help teens – both boys and girls – who need someone to talk to. You can find out more about them at this link : http://www.boystown.org/hotline

The most important thing I want you to remember is that you don’t have to be alone with this confusion and pain. There are people in the world who dedicate themselves to helping kids like you. I also bet there are people in your family and in your school who will help you if you give them a chance.

Please write back and let me know how things go.

I wish you well.
Dr. Marie

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4-year-old won’t use potty

by Dr. Marie Hartwell-Walker October 13th, 2019
written by Dr. Marie Hartwell-Walker

My son was looked over by psychologist and all that. He was diagnosed with a learning disability. he is developmentally delayed in speech and in other areas. he goes to a special class for speech, socialization, and school readiness skills. his teachers tried all school year with the potty training as well as i and it did not work he would sit on the potty for them but not for me. he is good about telling everyone when he is done using his diaper and when he needs it changed. but not so much as telling us before it happens. he will be back in the same program next school year in august and starts the preK classes. i am completed dedicated to all summer trying to get him in underwear before the start of school. we have a 14 month old so i cant make the diapers completely disappear from the house. i have already trained my son by age 3 and my daughter also before she turned 3, but they did not have the learing disorder. so they were easy to talk to and reason with and they understood more. to start him off i put him straight into underwear because that morning his diaper was completely dry still from the night before. problem is he does not go potty at all and i dont want him to get and infection. so i put him in a warm tub and made him stand up. he was scared at first when he first started peeing but then i calmed him and he got to hear and focus on what it is supposed to feel like going pee and not in a diaper. and i saw later that day he was getting ready to poop his pants but i caught him and ran him to his potty and we successfully pooped in the potty. that was yesterday. today which is great he did not pee is pants but he came up and said potty but he asked for the bath so i put him in the tub again so he can understand the feeling. but now i think he thinks he is supposed to go in the tub. was that a mistake? and wasnt so successfull in cathing th BM this time. it ended up on the floor. he just refuses to go on the potty. he will sit on his little potty for hours and nothing. we recently had a hernia operation too about 4 months ago and it was a successfull operation and its all healed. so i dont know if that has anything to do with it. sorry this is so long. i just wanted to give you as much info as possible. we even talked to the pediatrician. and he said dont push him. i am trying not too. and we have a sticker chart and book. he is not affected by it at all and shows no interest in it. please HELP!!

Thank you for writing. You certainly have your hands full with four kids. (I do too and I remember it well.) It must be very, very frustrating to be putting in so much effort and getting so little result.

The first thing I’d like you to do is find a moment to sit quietly and just take a few deep, long breaths. Then let’s take a look at the whole situation. You’ve told me your son has some developmental delays. That probably means that he will be delayed in toileting as well. You also said that he had a hernia operation recently. (4 months ago is like yesterday to a little kid.) He may associate pain with his abdomen and be fearful of doing a bowel movement. If so, he delays it as long as he can. He’s also made a connection now between a bath and peeing. Since he is delayed, you’re right to wonder if he knows that he isn’t supposed to use the tub now. And, on top of all that, toileting has become very, very important. In a household of a lot of kids, he may have found that a way to get your undivided attention and concern is around potty issues. Whew! No wonder this has become such a problem.

You didn’t mention your husband’s involvement. If he can, I think it might be helpful for him to take over in this department for awhile. He and your older son can show your little boy how boys pee in the potty. They can even make a game out of it. Suggest to Dad that he throw a few of those oat cereal circles in the potty and make it a contest to see who can hit them with pee. (Yes. Really.) Your older son can challenge him to a peeing race to see who can pee the most, finish first, etc. (in the potty, of course). The point for everyone is to relax about this and to make going in the potty more rewarding than not. The other point is to give you a break!

Your son will likely take another year or two to master all the skills of toileting. It’s okay. The fact that he is making some improvement even now shows me that he can. He’s just going to do it later. Let the teachers know that you are taking another approach and see if they can do the same at school. If you can take the stress off the issue, it may help everyone.

I wish you well.
Dr. Marie

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Caught between gf and mom

by Dr. Marie Hartwell-Walker September 1st, 2019
written by Dr. Marie Hartwell-Walker

I’m a European expatriate stationed in Asia who, as of the last 6 months, lives with my girlfriend of 3 years. Apart from a few conquerable problems we’ve had a good relationship that started shortly after I started my foreign assignment. I love her and I know she loves me. We both planned to spend the rest of our lives together.

Then we ran into some serious problems when my mother recently visited for two weeks. My girlfriend met my parents 2 years earlier for a few days, when we traveled to my home country, and the meeting went fairly well. I’ve only met her parents shortly one time. This time however, my girlfriend-for a number of reasons-got the feeling that my mother doesn’t like her. Moreover, and more importantly, she was shocked by the way my mother touched me.

My mother has always been one to hug, caress, and touch me and my brother, or any child for that matter, extensively and she continued with that even as we grew old. Specifically there was one event-which perhaps was a bit extreme even for my mother-where my mother stroked my leg and fiddled with my neck while my girlfriend sat next to me.

I, who are used to the touching, did not react strongly to this and when my girlfriend thought it sick I initially brushed it away by saying, “Just ignore it. My mother treats me like a child. That’s just how she is.”

That did not help, of course. My girlfriend believes the touching might be sexual and the problem is that I don’t see it, or take it seriously enough. I had a hard time doing that since my father (mother and father are divorced since my birth), brother, and I guess close family have seen this touching without ever commenting on it. In my family it is not strange, which then of course becomes a problem. Also I don’t see how it could have any real effect on my life, especially since I’m not the one doing it.

However, since I no way want to hurt my girlfriend, who is the most important person in my life, I changed my defensive stance and agreed to never let my mother touch me like that again. I also told this to my family, but my mother was not really willing to accept it, even if I think she will in time. She thinks it important for people to touch each other.

How that situation will play out I don’t know, since I only meet my mother about once per year, and my girlfriend meets her even less.
My girlfriend still wants to break up with me though, since she feels I have not changed my attitude enough, or understood the depth of this problem. She also thinks I care more about my mother than her, because of this, and perhaps that I should be more angry with my mother.

I’ve tried to show my girlfriend that she is the one I care about and I also thought that came natural since I’m spending my life with her. It hurts her tremendously that I cannot see the seriousness of the situation. She also thinks I’m too nice to my mother and that my mother depends too much on me. I am nice to my mother and to my whole family, I will not refute that, and my mother does depend on me to some extent since she lives alone in a big house and sometimes needs help. But honestly I have a hard time understanding what impact this can have on my relationship, especially when I meet her rarely. She calls me about once per week for 15-30min and my girlfriend now thinks those phonecalls come too often and are too long. She believes I need to distance myself even more from my mother, at least until there is a change.

I love my girlfriend and I care first about her and me, but because of these events she has lost faith in me. I’ve hurt her so much that she cannot believe me anymore.
Now I don’t know what to do. I would do anything to fix my relationship, but shutting out my mother and with that the rest of my family doesn’t seem like a healthy solution. Also I still, to some extent, fail to see how this could break a relationship.

What you may be experiencing is a difference in cultural values, not a question of what is “right.” Your mother’s behavior may mean entirely different things to the two of you. Instead of arguing about your mother’s behavior, you might do better to explore what is expected of a mother-in-law in her culture as opposed to yours.

On the other hand, it does sound as if your mother was consciously or unconsciously feeling a little competitive with your girlfriend (who gets to be with you all the time) when she was touching you so intimately in front of her. This may be what your gf was picking up and reacting to.

The fact is there’s touching and there’s touching. Your gf is right to ask that you not allow your mother to touch you in ways that are more appropriate to lovers – like stroking your leg. But it’s unreasonable to expect that you and your mom won’t make at least some of your family’s style of physical contact, especially when you don’t see each other often.

As for the reaction to a weekly phone call, I have to wonder why your gf feels so threatened by that. Do you behave differently toward her after the call? If she doesn’t have a close relationship with her own family, perhaps she is jealous? Have you and your mother done enough to include her in your family or does your gf feel closed out when mom is around?

In short, I think that there’s more to this difference of opinion than meets the eye. If you want the relationship to last, you and your gf have some important talking to do. You two aren’t kids. I’m hopeful that you can find a way to expand your love to include members of both families.

I wish you well.
Dr. Marie

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Why can’t she stop lying?

by Dr. Marie Hartwell-Walker January 1st, 2020
written by Dr. Marie Hartwell-Walker

Hello,

I really, truly believe that I have a problem, but I have no one to talk to about it.

I lie; much more than I should. I am a 16 year old girl, and though I’d like to consider myself mature for my age, I make up these stupid lies, to the point where I have basically created a whole identity that isn’t even me anymore. I have always sort of charmed my way out of things with white lies, but I have NEVER lied about anything to this degree before now.

It started getting bad about a year ago. I was feeling pretty bad about myself, and I had grown distant from my friends. My parents were away, so I planned an elaborate trip to another city which is over 50 miles away– and I planned to go by myself. However, I ended up not going and chickening out, but I told my friends that I went anyways.

I proceeded to tell them that I had gotten hopelessly lost and didn’t have enough money for a taxi, when a stranger helped find me a ride to the station. This stranger was handsome (of course), but I described him in a way that made it sound realistic to them. I told them that he went to the art school there, and that although I was distrustful at first, that he seemed like a very genuine guy. His name was Andrew, and he was 20. This was all a lie of course.

As weeks went on, I would avoid my friends on weekends, and then when monday would come around, I would tell them that I was gone visiting this fictitious guy. All of my friends believed me, and I got used to weaving this fantasy person in my life. He wasn’t perfect, he had flaws too and we had problems. I told them we fought a lot because he thought I had a thing for his friend, random things like that. Every lie I told, although it sounds ridiculous written down, was very believable. I feel very bad about it afterwards, but I was very good at manipulating them to believe me even though they never actually met this person. Lying was becoming very natural. Most liars lose track of the lies they have told, but I never have.

Then I REALLY started to lie too much. I obtained a wrist injury, purely by accident– but I told my closest friend that “the guy I was seeing” grabbed me too hard. Now I am lying about physical abuse… What is wrong with me?! My lies are becoming dangerous, and I KNOW that, but I can’t seem to stop it.

Lying is an automatic response now, as if I truly believe in my lies– but I don’t! Basically, I really feel that this is all spiraling out of control. I don’t even know why I did this to begin with. It’s actually gotten to the point where it’s almost like he DOES exist to me. I automatically integrate this fictitious person in my life. I KNOW it’s not real, but it’s like I am starting to actually convince myself that he is. It’s getting out of proportion, and I can’t stop! It just… happens somehow. I feel like a horrible person, but I’ve been totally programmed to just LIE about it– but only about this double life.

I’m so frustrated with myself. I have taken AP psychology before, I’ve tried analyzing myself. I don’t feel like I have a lying disorder– it’s more like I have identity issues? I live in my dream fantasy world quite often, and now I’m starting to incorporate it too much into the real world in the form of lies.

I don’t know how to stop– I WANT to stop, but I don’t want to come clean about everything, because all that would do is make my friends think I’m insane. Maybe I am? I don’t know what to do!

I guess what I really need advice on, is the reason why I have created this double life? I feel like no one knows the real me anymore. This huge lie has become too much of my identity to other people.

Thank you for reading all of this.

And thank you for writing. It takes courage to face up to a situation like this. You answered your own question. You created this alternative life initially because you felt bad about yourself and you didn’t think your real life was very interesting. Being creative and intelligent, you made up an alternative life that seemed much, much more exciting. For awhile, it was also kind of exciting to see how much lying you could get away with. The energy that comes from playing with “danger” gave a little zing to your life.

The problem is that these things begin to take on a life of their own. What began as a way to help yourself has now turned into an even bigger problem. That’s where you find yourself now. If you tell your friends the truth, you risk losing them. If you don’t stop lying, you will feel worse and worse about yourself. So you avoid the issue as much as you can. But there’s a cost to putting off the truth. Yes, you don’t risk the friendships. But you also do feel worse and your self-esteem sinks even lower. Your system isn’t working any more.

Writing your email was your first step in making the situation better. It took courage to put all that information in one place. It took courage to be that honest. Writing was a small step but an important one because it shows that a part of you has the strength to make change.

The next step is to get some support for yourself. You’re probably going to need someone to be a sounding board as you figure out how to make things right. A counselor can offer you non-judgmental support and perhaps some practical advice. She or he can also help you remember all the positive parts of you that you may have forgotten because you are so distressed. Getting in touch with the positive will help rebuild your self-esteem and will give you the strength you need to get things back to normal.

Please take that next step. You’re worth it.

I wish you well.
Dr. Marie

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Husband in military wants a divorce

by Dr. Marie Hartwell-Walker December 30th, 2019
written by Dr. Marie Hartwell-Walker

My husband is in the military and under a lot of stress right now, and I fear it may be having a very negative impact on him. For years now he’s been really detached from everything. He has no friends, he doesn’t do much with his life. He works and he plays World of Warcraft and that’s about it. He was a completely different person when we first got married. He hadn’t been in the military very long, and he was very full of life. He had hobbies and friends. He enjoyed getting out and doing things, but the more time he spent in the service, the worse he became.

Eventually he just stopped doing much of anything. He stopped talking to friends, didn’t spend as much time with his family, even his hobbies seemed to be slipping. I didn’t think anything of it at first, but maybe I should have. I figured it was just stress and it would go away eventually.

He’s seeing a therapist, but I’m not sure how often. I remember him saying once that they’d said he had OCD and had suggested that he might be schizotypal. He’s told me several times that he feels like his mind is splitting and thats why he has mood swings. One minute he’s friendly and caring, and the next hes very cold and distant. Naturally I was concerned, but I have no idea what to do.

We’ve been married five years (just had our 5th anniversary yesterday). We haven’t seen each other in two years due to him being in the service, though I did see him for two weeks over Xmas break. During that two weeks things seemed fine. We spent time together and we had fun and he seemed very in love with me. A few weeks ago he called me out of the blue to say he wanted a divorce.

His reason for this has changed several times. First he didn’t love me anymore, which I just can’t believe. Then he felt trapped and wanted to be free. Then he wanted the chance for us to start over fresh and correct past mistakes. Then I wasn’t the kind of person he wanted to be married to. He wants someone with a good work ethic, and I admit that mine is severely lacking, but I’m making up for that now. I’m fixing my mistakes, but I’m still concerned for him.

He won’t talk to me because he says talking to me hurts him. When he thinks about the good times and leaving it all behind, he feels hurt. To me, and I may be wrong, that says that he’s not sure that leaving is the right choice. But he’s avoiding his feelings. He’s cutting himself off from everything. I feel like he’s trying to shove the issue and his feelings under a rug, in hopes that they will just go away. As long as he avoids talking to me or talking about our relationship, he doesn’t have to face the fact that he may not be making the right choice.

I believe his detachment from everything is one of the (if not THE) key factor in the downfall of our relationship. So now I don’t know what to do. Do I just sit here and let him deteriorate even more and let what’s left of our marriage (as well as our friendship) fall apart completely. Or do I do something about it? I realize I can’t force him to stay with me, I’m just worried about his detachment. Not just from me, but everything. I don’t know who to voice my concerns to about it. I have no idea who he’s seeing, and there’s no way for me to find out. He wouldn’t tell me, and due to confidentiality, I can’t find out anywhere else.
What should I do? He doesn’t want to talk to me, and if I tell him I’m concerned, it may just push him further away.

Your husband sounds significantly depressed and perhaps at risk for hurting himself. He may be pushing you away in the mistaken idea that it then won’t matter to you. Military life takes its toll on people whether or not they are in active combat.

I strongly urge you to call the chaplain connected to his unit and share what has been going on. Please don’t be concerned about your husband being mad at you for interfering. Better to live with “interfering” in a way that might help him than to live with not doing so and having something happen to him. The rules of confidentiality allow for you to share information even if the person you are talking to can’t give you details in response.

You may also find some help for both of you at this website:

National Military Family Assn

Military life can be hard on the whole family. If you haven’t done so already, I hope you will reach out to a military family support group in your area. Your problem is not unique. Other spouses left behind can help you feel less alone and give your you practical advice.

I wish you well.
Dr. Marie

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Infatuated With Someone With Schizophrenia

by Kristina Randle, Ph.D., LCSW March 11th, 2019
written by Kristina Randle, Ph.D., LCSW

I work in a boarding house/assisted living facility where most of our residents are mentally ill. I’ve been in this field for about 3 years. I’ve worked mainly with the elderly, rehabilitating or those with dementia. I’ve been with my current employer for about 7 months. Working with the mentally ill is new to me, but I’m adapting well and coming to understand what I’m dealing with more and more.

Over the months of my occupation at this facility I’ve had a growing interest in one of our residents. He’s a 37 year old man who has schizophrenia. At first it was a mild curiosity. Now I’m so preoccupied with thoughts of him that I have to mentally slap myself into reality when I’m at work to finish basic tasks.

He’s quite withdrawn and impassive. I understand that this is a basic symptom of his condition. Just in the last few months I’ve noticed some positive changes in his countenance that bring me great joy. I’ll see him smile and lightly giggle to himself when he thinks no one is watching. Lately I’m able to identify what he finds amusing and this also pleases me because the cause is appropriate to the corresponding emotion. This gives me hope that his illness isn’t as serious as it could be.

I have come to find him terribly attractive and my heart changes pace when he chooses to look me in the eye and speak to me. I feel like I’m the only person on earth when he finds the courage to communicate with me without prompting. I have difficulty getting him off my mind. When I’m at work I hope that he will ask me for something just to have a chance to interact with him. When I come home I think about him and daydream of being able to hug and kiss him until I fall asleep. The sad thing is that I haven’t slept much in lue of these thoughts.

I think about leaving my place of work just so it could be ethical for me to take him to a movie or to dinner, but then I have to wonder if there’s something wrong with me. Am I infatuated with this man for the wrong reasons? Would I be a threat to his mental stability if I pursued some kind of romantic relationship with him? Or would it actually be helpful to his recovery to have an interested female in his life?

His face sheet does not tell me anything about his history or how he came to be one of our residents. I can only speculate, but I’ve often wondered. He seems so much more adjusted than any of our other residents, despite his withdrawal which is slowly dissipating.

I’m well aware that if I successfully established the beginning of a dating relationship with such a person that some of my more common needs may not be met. His is a selfish disease. I do not care. I would be willing to set aside my needs for his just to have the closeness with him that I crave.

I’m unsure how to handle this. I’m sure he’s aware of my adoration of him. It’s all I can do not to just wrap my arms around him and tell him how lovely and wonderful he is. I will not violate the ethics of my job, but my infatuation with this man is quite powerful. I am confused and sad with this situation.

It’s kind and thoughtful of you to care so much about one of your patients. Working with individuals who have schizophrenia can be challenging and it’s good to know there are people who care about helping them recover.

You are faced with a difficult situation. The goal for you in this situation should be to do what is best for the individual you are caring for. His mental health and stability should be your utmost concern.

You mentioned that you did not want to engage in unethical behavior. Fantasizing about him is unethical. Remember that he is currently your patient and you are his attending caregiver.

Most relationships do not develop like the one you’ve described. You said that you would forgo your needs to be with him. It’s not healthy for you to do this. You’d likely be okay with not having your needs met at first but after a short while you may begin to feel resentful towards him because he could not meet them. One-sided relationships usually do not last very long.

There are also other important factors to consider. You do not know his history. Usually individuals who live in residential living facilities have very serious illness histories. He may be severely mentally ill. If so it may be difficult for him to engage in a relationship. You said that he is withdrawn and quiet. This may be due to illness symptoms or it could be related to the medications he is taking. With regard to medications, we do not know how they are affecting him emotionally. Some medications cause a person to be withdrawn or to have a flat affect. Medications also change an individual’s personality. If he were to eventually come off of his medications he might be a completely different person.

You also thought that you could help him recover from schizophrenia if you and he were together. You seem to believe that your love could help him be cured of schizophrenia. That’s almost like saying that love cures schizophrenia. That line of thinking is an insult to the families and spouses of individuals who have schizophrenia. If we asked them how much they love their family member with schizophrenia we’d almost assuredly find that they very much love their ill family member. But love can’t cure schizophrenia. He is mentally ill. His disease is very real. It’s unrealistic to think that your love can cure his schizophrenia.

I understand that you may not truly believe that you could cure his schizophrenia. You are trying to help him. It seems like you are a caring individual. Your desire to help him is very noble and kind but it’s important to be realistic.

The aforementioned information contains several important points to consider. Given the situation if your goal is to help him recover then it may be best for you to remain in the role of a caregiver. I would advise against attempting to pursue a relationship with him. He could be best served by your help, generosity and kindness with you as a caregiver. The last thing you want to do is to harm him. Engaging in a relationship with him has the potential to harm him while remaining his caregiver could only benefit him. I would suggest you do the latter.

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